Increasing steroid hormone receptors expression defines breast cancer subtypes non responsive to preoperative chemotherapy.
The predictive role of the degree of endocrine responsiveness to preoperative chemotherapy (PCT) is unclear. We reviewed pretreatment biopsies of 553 patients with locally advanced breast cancer who were treated with PCT. The incidence of pathological complete remission (pCR) and outcome were assessed with respect to the degree of estrogen (ER) and progesterone receptor (PgR) expression (ER and PgR absent, vs. ER or PgR 0-49%, vs. ER and PgR >or=50% of the cells positive). A statistically significant higher pCR rate was observed at the multivariate analysis for patients with ER and PgR absent tumors (17.7%) versus patients with tumors expressing high ER and PgR (0%) (OR 14.4 P < 0.001). Despite the higher incidence of pCR, a statistically significant worse disease-free survival (DFS), and overall survival (OS) was observed for patients with ER and PgR absent tumors versus patients with tumors expressing high ER and PgR (HR 6.4, 95% CI 3.5-11.6, for DFS; HR 3.6 95% CI 2.4-5.6 for OS). Response and outcome after PCT are correlated with the degree of expression of steroid hormone receptors. Studies on tailored preoperative therapies are needed.
Colleoni
Marco
M
Department of Medicine, Research Unit in Medical Senology, European Institute of Oncology, Milan, Italy. marco.colleoni@ieo.it
Bagnardi
Vincenzo
V
Rotmensz
Nicole
N
Gelber
Richard D
RD
Viale
Giuseppe
G
Pruneri
Giancarlo
G
Veronesi
Paolo
P
Torrisi
Rosalba
R
Cardillo
Anna
A
Montagna
Emilia
E
Campagnoli
Elisabetta
E
Luini
Alberto
A
Intra
Mattia
M
Galimberti
Viviana
V
Scarano
Eloise
E
Peruzzotti
Giulia
G
Goldhirsch
Aron
A
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy / Q000378:metabolism* / Q000473:pathology; D018572:Disease-Free Survival; D019008:Drug Resistance, Neoplasm / Q000502:physiology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D020360:Neoadjuvant Therapy; D011960:Receptors, Estrogen / Q000096:biosynthesis*; D011980:Receptors, Progesterone / Q000096:biosynthesis*
D000970:Antineoplastic Agents; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone